Journal of Cancer Education

, Volume 33, Issue 6, pp 1314–1322 | Cite as

Testicular Cancer on the Web—an Appropriate Source of Patient Information in Concordance with the European Association of Urology Guidelines?

  • Pia Paffenholz
  • Johannes Salem
  • Hendrik Borgmann
  • Tim Nestler
  • David Pfister
  • Christian Ruf
  • Igor Tsaur
  • Axel Haferkamp
  • Axel HeidenreichEmail author


Despite the continuous growth of the internet, little is known about the quality of online information on testicular cancer, the most common solid malignancy in young men. In our study, we analysed the quality, readability and popularity of the most popular websites on testicular cancer. Therefore, we performed a web search for the term “testicular cancer” using Fifty-one websites were evaluated for HONcode quality certification, Alexa Popularity Rank and readability levels. Furthermore, the websites’ content on eight major topics of the current European Association of Urology Guidelines on testicular cancer was assessed. Fourteen (28%) had a HONcode quality certificate and the mean Alexa Popularity Rank of all 51 websites was 54,040 (interquartile range 6648–282,797). Websites were difficult to read requiring 9 years of US school education to properly understand the information. The websites mentioned 80% of the guideline topics on average, revealing “prognosis” (59%) and “follow-up” (57%) as underrepresented subtopics. Furthermore, 12% of all topics were displayed incorrectly, particularly due to wrong information concerning “aetiology” (42%). Sixty percent of the topics were mentioned in an incomplete fashion, with less than half of the websites displaying complete information on “staging” (47%), “diagnostic evaluation” (49%) or “disease management” (45%). In general, online health information concerning testicular cancer is mentioned correctly on most websites. However, improvement regarding readability and completeness of the given information is needed. Nevertheless, highly selected websites on testicular cancer can serve as an appropriate source of patient information.


Internet Germ cell tumour Websites New media Patient education Health literacy 



Bleomycin, etoposide, cisplatin


European Association of Urology


Etoposide, cisplatin


International Germ Cell Cancer Collaboration Group


Interquartile range


Standard deviation


Testicular cancer


Testicular intraepithelial neoplasia


Paclitaxel, ifosfamide, cisplatin


Vinblastine, ifosfamide, cisplatin


Etoposide, ifosfamide, cisplatin

Supplementary material

13187_2017_1249_MOESM1_ESM.xlsx (21 kb)
ESM 1 (XLSX 20.9 kb)


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Copyright information

© American Association for Cancer Education 2017

Authors and Affiliations

  • Pia Paffenholz
    • 1
  • Johannes Salem
    • 1
  • Hendrik Borgmann
    • 2
    • 3
  • Tim Nestler
    • 4
  • David Pfister
    • 1
  • Christian Ruf
    • 4
  • Igor Tsaur
    • 2
  • Axel Haferkamp
    • 2
  • Axel Heidenreich
    • 1
    Email author
  1. 1.Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive Urologic SurgeryUniversity Hospital CologneCologneGermany
  2. 2.Department of UrologyUniversity of MedicineMainzGermany
  3. 3.Vancouver Prostate Centre, University of British Columbia, Jack Bell Research CentreVancouverCanada
  4. 4.Department of UrologyFederal Armed Forces Central HospitalKoblenzGermany

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